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Vitamin D Deficiency - Causes, Symptoms and Treatment
contents
- The sunny mind
- Vitamin D responsible for the skin color?
- Pale nobles and coal children - vitamin D in modern times
- The Importance of Vtamin D for Babies
- Risks for vitamin D deficiency
- Symptoms of vitamin D deficiency
- Treatment of vitamin D deficiency
- Vitamin D overdose
- Beware of epilepsy medication
Helena, a sufferer, writes: "I have had a creeping fall in my performance over the past two years, which eventually ended in massive memory, concentration problems, inner restlessness, exhaustion. Constantly I felt irritable and increasingly overwhelmed, even in private life. Increasingly, I had depressive phases. At the same time, I was chronically irritated internally. Back pain plagued me for many months. My colleagues were seriously worried, so they approached my boss, who sent me on a forced break. I tried to recover. After a 2-week period in the sun, I already felt better. "
Using sunlight and nutrition to prevent vitamin D deficiency. Image: bit24 - fotolia The sunny mind
Since time immemorial, people have known that the sun brings (in moderation) positive emotions, and many Germans flee to Spain in the cold season or to Thailand in the meantime. Popular stereotypes call "southerners" a "hot temper", while Russians and Scandinavians are considered melancholy and "cold". These ideas inspired both obscure and dangerous racial theories. Thus, the founder of the irrational "anthroposophy" allegedly suffering from schizophrenia fantasized that "the Negro" had a black skin, "because the heat boils in his blood".
In fact, suicide rates are high in northern Russia and Scandinavia, as is alcohol abuse: depressions are widespread in countries where there is no sun for months, and those living there are now helping themselves with UV rays from the solarium. Cod liver oil and cod liverwort are considered the aspirin of Norway and the Arctic - and not without reason.
The organism forms vitamin D mainly with the help of sunlight on the skin. Even foods contain vitamin D, but this is only a fraction of what we absorb through the sun.
Vitamin D is not a vitamin in the narrow sense, because vitamins are organic substances that the body absorbs - vitamin D, on the other hand, is produced by the organism. Few foods contain vitamin D, especially fatty fish such as eel, herring, salmon and especially cod liver, but even dietary supplements can not give us enough vitamin D to maintain good health.
How much vitamin D the body needs varies with age, body weight, percentage of body fat, skin color, latitude, the use of sunblocks, individual exposure to the sun, and underlying conditions or general physical condition.
Vitamin is fat soluble and is stored in the liver and adipose tissue. Therefore, people with a lot of body fat have the ability to store a lot of vitamin D and at the same time keep it from being metabolized in the body,
Ultraviolet rays in sunlight change cholesterol in the skin into vitamin D. For a fair-skinned person, 20-30 minutes of sunlight a day on the face and fore-arms will be enough for two or three times a week at noon, in the summer months in Germany or the UK to produce enough vitamin D. However, people with dark skin and / or older age need much more time to have enough vitamin D available.
A simple blood test can determine the level in the blood. Vitamins are measured in nanograms per milliter. 20 ng / mL to 50 ng / mL is an adequate level for bone and overall health, while a level below 12 ng / mL implies a vitamin D deficiency. Many experts believe that a higher level of 35-40 ng / mL is needed to permanently stabilize health. Higher levels have no additional benefit.
Vitamin D responsible for the skin color?
In 2003, George Chaplin and Nina G. Jablonski posed the thesis that humans' black and white skin was an adaptation to too much and too little sun. This would have been a balancing act.
UV rays could be devastating to the naked skin, and reddish brown to black melanins are a natural sunscreen and prevent skin cancer. Particularly skin cancer endangered people with fair skin in regions with strong sunlight such as Anglo Australians.
However, people with light skin would also have low levels of folic acid in their blood after exposure to strong artificial sunlight. If human blood serum is irradiated with artificial sunlight for one hour, then the content of this B vitamin is reduced by half.
Folic acid deficiency, in turn, leads to severe disabilities in newborns, leaving sections of the spinal cord exposed, as well as the cleft lip and palate. To prevent this, pregnant women in the US and Europe are recommended to take folic acid supplements. B vitamin is found mainly in egg yolk, liver, wheat germ and leafy vegetables.
According to the researchers, dark skin was created to protect the folic acid in the body from UV radiation. In the sun-poor north, however, hardly any UV-B penetrated the skin anyway. But this was not a relief, but a problem, because UV-B rays are dangerous, but also vital, because they trigger the synthesis of vitamin D and thus have elemental importance for calcium and phosphate metabolism, in turn, the bone structure controls.
So the skin in the northern latitudes had to get light to absorb enough UV-B rays for humans to produce the vitamin. Without D-vitamins, the body can not absorb calcium from the gut that makes up the bones and the skeleton can not develop normally. Without calcium, the immune system also breaks down. These relationships have been further underpinned by Michael Hollick of the University of Boston (Massachusetts) and his colleagues over the last two decades through their medical studies. They also showed that sunlight at higher latitudes in winter is insufficient for production because too little UVB radiation reaches the skin. North of the 50th parallel, ie altitude Frankfurt am Main, according to Chaplin and Jablonski, people would suffer for half a year and longer under vitamin D deficiency, or compensate for this by food.
Therefore, people in the far north would never really turn brown, because their skin should always catch as much sun as possible, while mid-latitude people would become dark in summer, and in winter their skin would turn a dull color, with little sunlight at that time of the year to save, and to protect in the summer from too strong sun. In the tropics, however, the radiation is so strong that even with protected pigments enough vitamin D is produced.
Although Inuit in Alaska, Greenland and Northern Canada have a darker skin, but first immigrated to the Arctic for about 5000 years, on the other hand, they had made themselves largely independent of the sun: Traditionally, the Inuit ate a lot of high-fat marine fish and thus the food with the highest levels of vitamin D.
In Africa, the Khoisan, the Bushmen of southern Africa, have a much lighter skin than the Bantu people near the equator, according to Chaplin and Jablonski, it is believed to be an adaptation to the lower levels of ultraviolet radiation in South Africa.
Today, people often do not adapt quickly enough to the sun in a new home, according to Chaplin and Jablonski, usually ignorant. This leads to diseases that have not yet affected the respective groups of people. For example, many Indians who came to Britain as citizens of the Commonwealth suffered from rickets and other vitamin D-Magel appearances in northern England and Scotland.
The skin colors of humans therefore have nothing to do with biological races, but only with adjustments to different environments and are the least significant feature to recognize groups of people.
Pale nobles and coal children - vitamin D in modern times
The history of vitamin D is primarily called rickets, a disease in which the bones soften and deform, and whose cause our ancestors did not know.
The disease itself, however, was described in England as early as the seventeenth century and was considered a disease of the fine people. At that time, it was mainly high society that got the disease: the poor, if they did not work in the mining industry, worked outdoors and got enough vitamin D. The aristocracy, however, defined itself by not having to work physically and put value, with a pale one To demonstrate skin color. Therefore, her skin did not absorb enough sunlight.
The industrial revolution made the lack and rickets a mass phenomenon - especially among children. Children were preferred in mines because they fit in the narrow studs. In addition came miserable hygiene and completely inadequate nutrition, which weakened the body.
Some of these buried child slaves did not see sunshine for weeks in the winter and pulled the coal carts for up to twelve hours a day.
At that time, rickets were called "children's bone disease". Affected infants had "pits" at the back of the head, because the skull bones soften and widened hydrocephalus. When the disease progressed, the skull rounded itself off, losing its longitudinal oval shape and looking like a ball. The base of the skull rose through the softening and the entire skull sank down. A typical symptom was a hydrocephalus with increased intracranial pressure and an exceptionally broad face.
The axes of the legs bent, and a ball belly developed, the chest deformed and the spine became crooked, as did knees and joints. In the second year of life, the body weight was so strong on the soft bones that the femoral neck lowered. The internal development of the bones was rotten and incomplete, the hips without strength, the abdominal muscles could not work without the hips, and those affected are chronically constipated.
The train of the diaphragm on the soft ribcage gave birth to a "chicken breast". The wrists swelled, especially the end of the forearm bones - the growth zones. The distance between the neck and shoulders was shortened by the diseased cervical spine. In the end, the bones of the children broke regularly.
In 1822, the Polish doctor Sniadecki recognized that farm children were less likely to suffer from rickets than those in Warsaw. In the late 19th century, Theodore Palm, a missionary, also observed that children near the equator did not get rickets and already suspected sunbathing as a potential cure and prevention strategy.
In 1918, Sir Edward Mellanby successfully cured dog rickets by feeding them exclusively porridge and keeping them indoors without sun, while curing rachitic dogs with cod liver oil - the food that contains the most vitamin D. This cod-liver oil was then known as a remedy for blindness and bone fractures.
McCollum realized that the antirachitic effect in cod liver oil was a new substance and gave her the name vitamin D. Hudshinsky discovered that sun healed children with rickets. Steenbock and Black noted in 1924 that UV-exposed food could also cure rickets, leading to the great realization that UV light was able to transform a food and skin-derived substance into another form. The findings suggested a close relationship between sun exposure and vitamin D..
The Importance of Vtamin D for Babies
Vitamin D deficiency in babies has the same causes as in adults: inadequate dietary vitamin D intake and lack of sun exposure, disorders that limit vitamin D intake or interfere with the delivery of vitamin D to the liver and kidney.
Vitamins and their sources. Picture: elenabsl - fotolia A shortage of babies can quickly have worse effects than adults, because the first year of a child characterized rapid growth, bone structure and formation of the spine. They are therefore particularly affected by rickets.
Children with chronic illnesses, especially those of the liver and children taking seizure medication, can sometimes take vitamin D poorly and the risk of rickets increases. Vitamin D deficiency also makes babies more susceptible to infectious diseases.
Children who are nursed by the breast do not receive vitamin D because their content in breast milk is minimal. If a nursing mother herself has a vitamin D deficiency, it will be even more difficult for the baby to get enough of the substance. Children who are given commercial baby food usually do not need additional vitamin D because it is already included.
Risks for vitamin D deficiency
People with dark skin are at a higher risk than fair-skinned people. People who spend little time out during the day are lacking vitamin D because they do not receive enough sunlight, such as home-bound night workers or long-term hospitalized patients.
Also at risk are people who cover their skin with sunscreen or clothing the entire time. This applies, for example, to women in Islamic countries who are forced to wear the niquab or the burka.
Low levels of vitamin D can also be used by people living in the far north - in Finland, Northern Russia or Alaska. Their skin does not receive sunlight for months at all.
Old people with muscle weakness can produce vitamin D poorly in the body, seniors are generally exposed to many risk factors: a thin skin, little sunlight and limited absorption of vitamin D in the liver and kidneys.
Obesity increases the risk for a low level, because the more weight a person has, the more vitamin D the human needs. Conversely, with the vitamin deficiency increases the risk of becoming overweight. Vitamin D and calcium suppress the appetite.
Symptoms of vitamin D deficiency
Depression and anxiety disorders
Vitamin D receptors are found in many parts of the brain. These receptors are also located in those parts of the brain where depression develops. Therefore, vitamin D deficiency is also associated with depression and other mental health problems.
An additional problem arises when the sufferer and doctors know nothing about the defect. They then search logically for psychological reasons for their mental health problems: relationships, professional problems or mental disorders. But triggering a vitamin D deficiency depressive moods, which has very little to do with a clinical depression. Those affected need neither a behavioral therapy nor a psychoanalysis, but UV-B rays and vitamin D supplements.
Excessive sweating
One of the first signals for a vitamin D deficiency is a sweaty head. Doctors ask mothers of newborns, therefore, if they sweat heavily. Excessive sweating is also an indicator of underproduction of the vitamin in infants themselves.
bone pain
A lack of vitamin D is manifested as pain in the bones, as muscle spasms and in the joints. People who do not have enough vitamin D can only consume 10 to 15% of their daily intake of calcium, according to a study published in the American Journal of Clinical Nutrition.
But this is necessary for stare and healthy bones. The result of missing calcium is weak, soft and aching bones.
osteoporosis
This disease is characterized by low bone mass and a decrease in bone tissue - the bones become fragile and bone fractures are the result. The cause is insufficient intake of calcium, but a vitamin D deficiency can lead to inadequate intake of calcium.
Osteoporosis is an extreme consequence of vitamin D deficiency and rarely directly traceable to it, but: Older people, postmenopausal women, and people who exercise too little can prevent osteoporosis with adequate levels of vitamin D and adequate calcium.
Erectile dysfunction
The deficiency also leads to an increased risk of erectile dysfunction. Vascular problems cause about half of all erectile dysfunction, and Vitam-D deficiency weakens the vessels. UV light is not only the most important source of vitamin D, it also increases the concentration of nitric oxide in the blood, which in turn reduces the risk of erectile dysfunction.
thyroid problem
Thyroid problems can be associated with vitamin D deficiency, but there is a scientific controversy about cause and effect. In any case, genetic dispositions, nutrition and general health also play a role. Autoimmune diseases play into thyroid problems, and with vitamin D as well as an insufficient supply like a genetic condition to be unable to produce them.
Frequent infections
Vitamin D plays a crucial role in the immune system. It strengthens the body's defenses to fight viruses and bacteria that cause disease. It interacts directly with the cells responsible for fighting infections. If someone gets sick often, especially if they have colds or flu infections, vitamin D deficiency can be the trigger. Several metastudies have shown that a deficiency associated with infections such as cold, bronchitis pneumonia.
anemia
Anemia occurs when the body does not produce enough red blood cells that transport oxygen to different parts of the organism. The cause behind it is probably vitamin D deficiency.
A study at the Johns Hopkins Children's Center found that people with low levels of hemoglobin also have low levels of vitamin D. Although the exact role of vitamin S and anemia is under further investigation, there is little doubt as to the link between anemia and vitamin D deficiency.
infertility
Vitamin D deficiency is linked to infertility, and couples who want to have children should have their levels examined. Research shows that women with adequate vitamin D levels tend to get pregnant and produce healthier embryos. Low levels in men also mean that the wish to have children is not fulfilled.
Two of the main parameters of sperm quality, namely exercise and shape, may be affected by vitamin D. When the sperm move slowly, they find it harder to get forward and fertilize an egg. In a study of 300 men with high vitamin D levels showed a higher proportion of mobile sperm. Conversely, in men with low vitamin D levels, sperm were less rapid and more sperm were abnormally shaped.
cancer
Vitamin D seems to destroy cancer cells and prevent cell division. One study, which was supposed to test bone health, found that menopausal postmenopausal women taking calcium and vitamin D had a 60% lower risk of developing cancer.
Vitamin D slows cell growth, a factor that could reduce the risk of most cancers by up to 50%. In contrast, deficiency of this vitamin suggests a 30 to 50% increased risk of prostate and breast cancer.
New research suggests that vitamin D is important for the body's immune system, giving certain genes the ability to work or not to work. That would be a logical explanation for the fact that vitamin D reduces the risk of cancer.
heart disease
People with too little or too much of the vitamin in their blood are at an increased risk for heart disease. Heart attack or heart muscle failure even doubles when the vitamin D level drops below 50 nmo / L. Heart death also increases as the vitamin D level increases above 100nmol / L.
Too high a level can damage the heart as well as the blood vessels and kidneys.
Low levels of dietary vitamin are associated with a greater risk of stroke, congestive heart failure and heart disease. On the flip side, high levels of vitamin D can cause toxicity and damage to the heart, blood vessels, and kidneys.
Treatment of vitamin D deficiency
The deficiency can be compensated with three methods: By sunlight, artificial UV-B light and dietary supplements.
How long it takes for someone to expose themselves to sunlight to produce significant amounts of vitamin D depends on a variety of physical and personal factors, and the environment also plays a role. Generally, the duration of the sun bath is to get a sufficient vitamin D level below the limit at which the skin burns and turns red. Therefore, short stays in the sun help to increase the vitamin D value to the optimum level.
In the temperate latitudes, such as Germany, it is important in the cold season to go out in the few hours when the sun is shining. In other words, anyone who walks the dog daily in daylight in December, rides a bicycle or otherwise stays outside will have fewer problems with his vitamin D budget, or none at all. It should be remembered that in the winter through the whole-body clothing less skin is exposed to the sun, which also radiates less intense. Therefore, to "fill up" vitamin D, it makes sense to take off mittens in between and put your hands specifically to the sun and not cover the face with a scarf.
Sunbeds can not completely replace the sunlight, and you should consult the artificial sunbed or have your vitamin D level measured. Excessive use of artificial UV light poses risks to health.
Moderate sunbathing helps to prevent a deficiency. Image: Jürgen Fälchle - fotolia Between the skin and the three wavelengths UVA, UVB and UVC is no ozone layer. UVC rays are dangerous to the skin and weaken the immune system. A higher dose of UVA and UVB than the natural sun provides increases the risk of skin cancer.
When used in moderation, sunlamps can normalize vitamin levels and thus reduce the risk of cancer - including skin cancer.
Vitamin D overdose
Even with vitamin D, there is "too much of a good thing". Excessive vitamin D levels are associated with the risk of anxiety, excessive urinary urgency, cardiac arrhythmia and kidney stones. An overdose of vitamin D can only be supplied by supplements - even intensive sun exposure does not lead to an increased level.
The sun only allows the body to produce vitamin D. The organism stops its own production, however, when a satisfactory level is reached. Vitamin D-rich foods such as cod liver, smoked eel or salmon make it virtually impossible to overshoot its level above normal levels.
Beware of epilepsy medication
Remedies for epilepsy can permanently lower vitamin D levels. Epileptics should regularly check their vitamin D levels, stabilizing them with sunlight, sunlamps, or supplements if it is too low. (Dr. Utz Anhalt)
Specialist supervision: Barbara Schindewolf-Lensch (doctor)